Castle Dental Practice

Inspection Summary

Overall summary & rating

We carried out a focused inspection of Castle Dental Practice on 14 November 2017.

The inspection was led by a CQC inspector who had access to telephone support from a dental clinical adviser.

We carried out this inspection focusing only on the well-led key question to check on information we had received relating to this aspect of care at this practice.

We carried out the inspection to follow up concerns we originally identified during a comprehensive inspection at this practice on 17 January 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:

Is it safe?

Is it effective?

Is it caring?

Is it responsive to people’s needs?

Is it well-led?

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area(s) where improvement was required.

At the previous comprehensive inspection we found the registered provider was providing safe, effective, caring and responsive care in accordance with relevant regulations. We judged the practice was not providing well-led care in accordance with regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Castle Dental Practice on our website www.cqc.org.uk.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements to put right the shortfalls and deal with the regulatory breach we found at our inspection on 17 January 2017.

Inspection report

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Inspection areas

Safe

No action required

Updated 16 March 2017

We found that this practice was providing safe care in accordance with the relevant regulations.

The practice had some arrangements in place for essential areas such as infection control, clinical waste control, management of medical emergencies at the practice and dental radiography (X-rays). We noted that improvements were required to the systems and processes underpinning health and safety systems including fire safety, conscious sedation and medicines management. We found that the equipment used in the dental practice was maintained in accordance with manufacturer’s instructions.

There were systems in place for identifying, investigating and learning from patient safety incidents although systems required improving.

Staff were aware of their responsibilities regarding safeguarding children and vulnerable adults and had received safeguarding training but five of the six staff had not been trained to the recommended level.

Inspection report

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Effective

We found that this practice was providing effective care in accordance with the relevant regulations.

The dental care provided for routine care was evidence based and focussed on the needs of the patients. The practice used current national professional guidance to guide their practice.

The practice carried out intravenous sedation for a small number of patients each year. We found shortfalls in the clinical governance systems that underpinned the provision of conscious sedation.

We saw examples of positive teamwork within the practice and evidence of good communication with other dental professionals. Staff generally received professional training and development appropriate to their roles and learning needs although there were gaps in training in some areas.

Inspection report

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Well-led

No action required

Updated 7 December 2017

We found that this practice was providing well-led care in accordance with the relevant regulations.

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated.

The practice team kept complete patient dental care records which were, clearly written and stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.

Inspection ratings

We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels:

Outstanding – the service is performing exceptionally well.

Good – the service is performing well and meeting our expectations.

Requires improvement – the service isn't performing as well as it should and we have told the service how it must improve.

Inadequate – the service is performing badly and we've taken enforcement action against the provider of the service.

No rating/under appeal/rating suspended – there are some services which we can’t rate, while some might be under appeal from the provider. Suspended ratings are being reviewed by us and will be published soon.

Ticks and crosses

We don't rate every type of service. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them.

There's no need for the service to take further action. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service.

The service must make improvements.

At least one standard in this area was not being met when we inspected the service and we have taken enforcement action.